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General NPI Number Information
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NPI Number | 1619332053
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Entity Type | Organization
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Legal Business Name | PHARMASCRIPT INC
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Dates
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Enumeration Date | 12/30/2015
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Last Update Date | 12/20/2020
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Provider Practice Location Address
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Address Line | 5437 N BROADWAY ST
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City | CHICAGO
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State | IL
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Zip | 60640
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Country | US
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Telephone | 773-681-0965
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Fax | 773-961-8907
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Provider Business Mailing Address
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Address Line | 5437 N BROADWAY ST
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City | CHICAGO
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State | IL
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Zip | 60640-1703
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Country | US
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Telephone | 773-681-0965
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Fax | 773-961-8907
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY OPERATIONS
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Name | MICHAEL GREEN
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Credential | PHARMD
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Telephone | 773-681-0965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 054.019406
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 054.019406
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | 054.019406
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License Number State | IL
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